AccountId: 011433970860
ContactId: d9e7e7da-2f46-4024-acb4-7bbdcdb40962
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 232990 ms
Total Talk Time (AGENT): 39678 ms
Total Talk Time (CUSTOMER): 97945 ms
Interruptions: 1
Overall Sentiment: AGENT=1.2, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/30/d9e7e7da-2f46-4024-acb4-7bbdcdb40962_20250430T18:33_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] It's
[CUSTOMER][NEUTRAL] Yes, my name is [PII]. I'm calling from Piedmont Healthcare to check claim status on a patient.
[AGENT][NEUTRAL] OK, [PII], I can help you with claim status. Do you have a good callback number, please?
[CUSTOMER][NEUTRAL] I can help you with.
[CUSTOMER][NEUTRAL] I do, yes ma'am, [PII].
[AGENT][POSITIVE] Great, thank you.
[CUSTOMER][NEUTRAL] Uh huh.
[AGENT][NEUTRAL] And the policy number of that patient?
[CUSTOMER][NEUTRAL] It is 01138856.
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] And it is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] And date of service and bill charges?
[CUSTOMER][NEUTRAL] [PII] and the amount of $1,058.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] And what type of services were those for?
[CUSTOMER][NEUTRAL] These were medical services for a dermatologist.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, it looks like it was denied as not covered when performed in a doctor's office.
[CUSTOMER][NEGATIVE] he was denied it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So is this just a hospital plan?
[AGENT][NEUTRAL] Uh, yes, correct. It's for outpatient hospital, um, services and inpatient as well.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hospital service only. OK, and can you verify the claims address that we need to mail claims to? I know you did get it, but we have two different claims addresses, so I just wanna make sure what we should be mailing it to. This one we sent to [PII] from [PII].
[AGENT][NEUTRAL] Sure, it's uh
[CUSTOMER][NEUTRAL] Let me see.
[AGENT][NEUTRAL] OK, yeah, that's the old address, yeah.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, alright, so should we be sending it to the [PII] City address?
[AGENT][POSITIVE] Yes, that's correct. Uh-huh.
[CUSTOMER][NEUTRAL] OK, perfect. OK, alright, and is there a claim number um associated with that claim?
[AGENT][NEUTRAL] Yes, it's 358-317-1.
[CUSTOMER][NEUTRAL] Yes, it's 358.
[CUSTOMER][NEUTRAL] 3171.
[CUSTOMER][NEUTRAL] And what day did that EOB go out?
[AGENT][NEUTRAL] Oh, that went out [PII].
[CUSTOMER][NEUTRAL] 41
[CUSTOMER][POSITIVE] OK, alright, we will just wait to receive that thank you so much.
[AGENT][POSITIVE] Thank you for calling APL. I hope you have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.